Intracranial lobar germinoma presenting with refractory hypernatremia

Central nervous system germ cell tumours are most commonly seen in the midline structures. Eccentric germinomas are rare but can be found in the basal ganglia, lobar, brainstem, and cranial vault. We present a 14-year-old boy who presented with signs and symptoms of overt diabetes insipidus and a radiological diagnosis of left frontal high-grade glioma. Confirmative histopathology revealed germinoma. The patient had a resolution of hypernatremia post-surgery and maintained normal sodium homeostasis on a single dose of 0.1 mg of tablet desmopressin. This paper showcases a rare case of an eccentric central nervous system germinoma in a young male patient presenting with Diabetes Insipidus without any apparent sellar or suprasellar involvement.